Certified Coding & CDI Audit Leader
Resume:
BREAN HOLMES, CPC, CPC-M, CPMA, CDEO
Janesville, WI
***.********@*****.***
PROFESSIONAL SUMMARY
Certified coding professional with over 15 years of experience in professional and facility coding, auditing, provider education, clinical documentation improvement (CDI), and revenue cycle operations. Experienced leading auditing teams, conducting provider and coder education, improving documentation quality, and ensuring compliance with AMA, CMS, ICD-10-CM, CPT, HCPCS, and payer-specific guidelines. Recognized for building strong relationships with providers, developing educational resources, and driving coding accuracy and documentation excellence across multiple specialties. CERTIFICATIONS
Certified Professional Coder (CPC)
Certified Professional Medical Coder- Master (CPC-M) Certified Professional Medical Auditor (CPMA)
Certified Documentation Expert Outpatient (CDEO)
CORE COMPETENCIES
• Professional Fee Coding & Auditing
• Clinical Documentation Improvement (CDI)
• Provider Education
• Coder Education & Mentorship
• E/M Auditing
• Medical Necessity Review
• Documentation Improvement
• Compliance & Regulatory Guidance
• CPT, ICD-10-CM & HCPCS Coding
• Teaching Physician, Split/Shared & Incident-To Guidelines
• Modifier & NCCI Edit Review
• Quality Assurance
• Audit Program Development
• Leadership & Team Supervision
• Revenue Cycle
• Microsoft Office Suite
SOFTWARE
Epic • Cerner • 3M • Meditech • ECW • MedHost • CPSI • CAC • AHS PROFESSIONAL EXPERIENCE
Health Information Associates (HIA)
Provider Consultant February 2026 – Present
• Perform comprehensive professional coding and documentation audits across multiple specialties.
• Review provider documentation for coding accuracy, medical necessity, and compliance with CMS, AMA, and payer guidelines.
• Identify documentation deficiencies and provide actionable recommendations to improve coding accuracy and reimbursement.
• Deliver individualized education and feedback to providers and coding staff on documentation requirements, CPT, ICD-10-CM, HCPCS, and E/M coding.
• Collaborate with clinical leadership to improve documentation quality, coding compliance, and audit outcomes.
Aspirus Health
Supervisor, Auditing, Education & CDI October 2025 – March 2026
• Supervised daily operations of the auditing, education, and CDI team.
• Led, coached, and mentored coding auditors while conducting performance evaluations and quality reviews.
• Managed audit workflows, productivity, project assignments, and departmental priorities.
• Developed educational initiatives to improve coding accuracy and provider documentation.
• Partnered with physicians, coders, and leadership to improve documentation quality and regulatory compliance.
WVU Medicine
Auditor / Educator June 2025 – October 2025
• Performed professional coding audits for providers and coding staff.
• Reviewed clinical documentation and provided recommendations to support accurate coding and medical necessity.
• Delivered provider and coder education through one-on-one sessions and department-wide presentations.
• Developed educational materials, coding guidance, and documentation improvement tools.
• Supported outpatient clinics and hospital departments across numerous specialties including:
o Dermatology
o Cardiology
o General Surgery
o Wound Care
o Otolaryngology
o OB/GYN
o Behavioral Health
o Neuropsychology
o Maternal Fetal Medicine
• Extensive experience with Teaching Physician, Split/Shared, and Incident-To guidelines.
SSM Health
Coding Educator December 2023 – June 2025
• Conducted provider and coder audits to improve coding quality and documentation.
• Developed coding tip sheets and educational resources.
• Led departmental education meetings and provider training sessions.
• Reviewed documentation for compliance with CMS and payer guidelines.
• Supported documentation improvement initiatives throughout multiple specialties. Mercy Hospital
Physician Auditor / Educator January 2023 – December 2023
• Audited physician E/M services across outpatient clinics and hospitalist services.
• Reviewed documentation to ensure coding accuracy and compliance.
• Provided education regarding documentation deficiencies and coding opportunities.
• Participated in quality improvement initiatives and special audit projects. Medical Record Associates (GEBBS)
Facility SDS Coder (Part-Time) March 2022 – Feburary 2026
• Assign ICD-10-CM and CPT/HCPCS codes for outpatient surgeries, emergency department, ancillary services, and same-day surgery encounters.
• Resolve coding edits and ensure compliance with coding guidelines.
• Helped with Auditing projects when requested
Healthcare Coding & Consulting Services (HCCS)
Facility SDS Coder September 2021 – January 2023
• Coded outpatient surgeries across multiple specialties.
• Assigned diagnosis and procedure codes.
• Reviewed anesthesia documentation and coding.
Monroe Hospital
Hospital Coder August 2015 – September 2021
• Coded inpatient professional services, emergency department, observation, urgent care, OB, and ambulatory encounters.
• Assigned CPT, HCPCS, ICD-10-CM diagnosis codes, modifiers, and NCCI edits.
• Supported specialties including Urology, Cardiology, OB/GYN, Gastroenterology, Podiatry, and General Surgery.
MSI
Medical Biller / Coder (Part-Time) February 2021 – November 2021
• Performed coding reviews, provider audits, medical billing, and payment posting. UnityPoint Health – Meriter Hospital
Follow-Up Coordinator August 2014 – August 2021
• Managed Medicare and Medicaid claims.
• Corrected coding and modifier-related denials.
• Submitted appeals and claim corrections.
• Managed provider-based billing and consolidated billing. Beloit Health System
Insurance Processor May 2013 – August 2014
• Processed Medicare and Medicaid claims.
• Corrected coding and modifier errors.
• Submitted appeals and claim resubmissions.
Walgreens Respiratory
Reimbursement Billing Specialist 2010 – 2013
• Managed Medicare billing and reimbursement.
• Obtained clinical documentation supporting medical necessity.
• Coordinated with providers regarding Certificates of Medical Necessity and qualifying documentation.
• Managed payment posting, denials, collections, and appeals. EDUCATION
Associate of Applied Science
Health Information Technology- June 2010
Rasmussen College – Rockford, Illinois
June 2010
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